Assessing the economic impact and healthcare resource utilization of inpatient pneumococcal disease among adults: a French national claims database study

Abstract

Background: Pneumococcal diseases (PD) caused by Streptococcus pneumoniae include invasive PD (IPD) and non-bacteremia pneumococcal pneumonia (NBPP). Current French vaccination guidelines focus on patients with underlying medical conditions (UMC) who are at a higher risk of PD. This study describes the healthcare resource utilization (HCRU) and economic burden of inpatient PD in French adults, to inform vaccination guidelines, especially among vulnerable subpopulations at increased risk of PD.

Methods: A retrospective study utilizing the French administrative healthcare database (SNDS) was conducted among adults with an inpatient PD episode between 2015 and 2018. HCRU and costs were described per inpatient PD episode, according to patient risk level, type of PD, and age group.

Results: Between 2015 and 2018, 42,466 inpatient PD episodes were identified. Most of the inpatient PD episodes (73.7%) occurred in patients with UMCs. The median (Q1-Q3) cost per inpatient PD episode seemed higher among medium-risk patients (€14,863 (€7,875-€30,434)) than among low-risk (€11,034 (€5,803-€23,098)) and high-risk patients (€13,258 (€7,143-€26,815)). Cost per inpatient PD episode did not seem to increase steadily with age, however, ≥65 patients represented 59.5% of all inpatient PD episodes and 52.3% of the overall inpatient PD episodes cost (€548,224,569 out of €1,049,214,069).

Limitations: Due to constraints of the SNDS dataset, results are limited to inpatient episodes of PD and may not be representative of all PD episodes in France.

Conclusion: This large, retrospective study highlights a substantial economic burden associated with inpatient PD in France, especially among individuals with UMCs and those aged 65 years or over. These results emphasize the need to improve prevention strategies, especially among older patients, regardless of their risk level.

Keywords: I10; I18; Pneumococcal infections; SNDS; economic burden; healthcare administrative claims; invasive pneumococcal disease; non-bacteraemic pneumococcal pneumonia.